Investigation of exercise capacity, respiratory and peripheral muscle strength and fatigue in patients underwent pneumonectomy for lung cancer

<bold>Background:</bold> Anatomical and physiological changes after pneumonectomy (PNX) possibly decrease exercise capacity, respiratory muscle strength and increase fatigue. Limited studies investigated aforementioned parameters in patients with PNX for lung cancer. However, no study investigated peripheral muscle strength, yet. <bold>Aims and objectives:</bold> To compare exercise capacity, respiratory and peripheral muscle strength and fatigue in patients with PNX and healthy controls was aimed. <bold>Methods:</bold> 14 patients with PNX and 17 controls were compared. Exercise capacity (6-minute walk test (6-MWT)), respiratory (MIP, MEP (mouth pressure device)) and quadriceps femoris (QF) (dynamometer) muscle strength and fatigue (Fatigue Severity Scale (FSS)) were evaluated. <bold>Results:</bold> Patients' 6-MWT distance, MIP and MEP, and QF muscle strength values were decreased (p<0.001) compared with controls. The resting values of dyspnea, fatigue, and QF fatigue, and delta (Δ) oxygen saturation, Δdyspnea, ΔQF fatigue, and FSS scores were significantly higher (p<0.005) in patients. Thirteen (92.86%) patients’ 6-MWT distance and MEP, and eight patients’ (57.14%) MIP were below 80% of predicted. Eight patients (57.14%) were severely fatigued. <bold>Conclusions:</bold> Functional capacity is severely impaired, and fatigue and dyspnea perception are increased in patients with PNX. During the exercise test patients were desaturated, and QF fatigue increased. Many of the patients had inspiratory and expiratory muscle weakness. Patients should be evaluated at the earliest stage and included in resistance training interventions targeting the lower limb and respiratory muscles, and aerobic exercise training.